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Plantar FascitisFRAMESNCT06106958

Effects of Foot Rehabilitation And Minimalist Shoes on Pain, Strength, and Function in Adults With Plantar Fasciopathy

A study testing Home Exercise Program and Minimalist Shoes in people with Plantar Fascitis and Plantar Fasciopathy, run by University of Virginia at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this clinical trial is to compare the effects of 8 weeks of foot rehabilitation exercises in conjunction with wearing minimalist shoes in individuals with plantar fasciopathy, compared to only performing foot rehabilitation exercises. Read more about this study

Who is it for?
Ages 18 to 55 years
What is being tested?
Home Exercise Program and Minimalist Shoes
Could I receive a placebo?
No, everyone receives an active treatment
How many people
37 participants
Where
1 siteUnited States
Study dates
14 Feb 2024to 20 Jan 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 55 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Between ages of 18 - 55 years old
  • First-step pain in the morning over past week - Visual Analog Score between 30-70 mm
  • Heel pain for at least a month with an insidious onset

Who cannot join

  • Other current lower extremity neuromusculoskeletal injury
  • Other lower extremity neuromusculoskeletal injuries other than the foot in the past 3 months
  • Previous history of foot/ankle fractures or surgeries
  • Current participation in formal rehab for plantar fasciopathy
  • Previous minimalist shoe experience

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Virginia

    Charlottesville, Virginia, 22903

Other trials in United States

About this study

Official title: The Effects of Foot Rehabilitation And Minimalist Shoes (FRAMES) on Pain, Strength, and Function in Adults With Plantar Fasciopathy

The goal of this clinical trial is to compare the effects of 8 weeks of foot rehabilitation exercises in conjunction with wearing minimalist shoes in individuals with plantar fasciopathy, compared to only performing foot rehabilitation exercises. The main questions it aims to answer are:

  • Will individuals with plantar fasciopathy be able to reduce their pain and improve their self-reported function by performing rehabilitation exercises and wearing minimalist shoes, compared to those only performing rehabilitation exercises?
  • Will individuals with plantar fasciopathy be able to increase their intrinsic foot muscle strength and size, their balance, and gait biomechanics by performing rehabilitation exercises and wearing minimalist shoes, compared to those only performing rehabilitation exercises?
  • What characteristics of individuals with plantar fasciopathy make them most suited to succeed in a protocol of performing rehabilitation exercises and wearing minimalist shoes?
Read more

Participants will be asked to come into the lab at the start of the intervention and after 8 weeks, where the following will be assessed:

  • Patient-reported outcomes
  • Foot morphology
  • Intrinsic foot muscle strength
  • Balance
  • Gait biomechanics

For the intervention, participants in both groups will perform the same rehabilitation exercises, including:

  • Massage to the bottom of the foot
  • Calf-raises
  • Calf and foot stretches
Read the detailed description

The purpose of the study is to determine the effects of 8-weeks of wearing minimalist shoes and performing a home exercise program (intervention group) on pain, self-reported function, intrinsic foot muscle strength and size, balance, and gait biomechanics, as opposed to receiving a home exercise program alone (control group).

All participants will report to the Exercise and Sport Injury Laboratory for a baseline clinical assessment performed by a blinded assessor to determine their level of pain and their self-reported function using a variety of patient-reported outcomes. These include pain levels on a Visual Analog Scale (VAS), Global Rating of Change to assess perceived changes in function, Foot Health Status Questionnaire (FHSQ) to gather general and foot-related health information, and a variety of scales that assess kinesiophobia, fear-avoidance belief, self-efficacy, and activity level. Functional measures include intrinsic foot muscle strength via diagnostic ultrasound, intrinsic foot muscle size via two different types of handheld dynamometer, balance via a single-leg balancing task on a force plate, and gait biomechanics via a walking task with insoles that can obtain measures of force and loading rate.

At the end of the first baseline visit, all participants will be taught how to perform the home rehabilitation exercise routine, and handed an informational sheet that will have pictures and links to supplemental videos to ensure that they understand the exercises and have the resources to review.

Immediately following the first baseline visit, participants will meet with another member of the study team to ensure assessor blinding. They will be randomly assigned to one of two groups: the intervention group of foot rehabilitation and minimalist shoes (intervention), or the control group of just rehabilitation exercises (control). The randomization sequence will be created a priori with a random-number generator stratified by sex, placed in sealed opaque envelopes by another member of the study team to blind the assessor. Participants in the intervention group will have a pair of shoes ordered for them, and they will begin the protocol when the shoes have arrived.

Participants in both groups will be instructed to fill out a daily survey that will be sent via text and stored in a secure server (REDCap), that will indicate if they have completed their rehabilitation exercises. Participants will also all wear Fitbit smart watches that will track their step count and some other health-related metrics. They will not be able to see their own data during the protocol.

At the 4-week mark of the study, all individuals will be sent a link to take surveys of patient-reported outcomes, including pain levels, self-reported function, kinesiophobia, fear-avoidance belief, self-efficacy, and activity level. They will also complete a phone call with a member of the study team (not the assessor, to maintain blinding) as a check-in to discuss pain levels and any other questions and concerns they have.

At the end of the 8-weeks, individuals will return to the lab to have the same measures as the baseline session completed. The investigators will then be able to determine if performing foot rehabilitation exercises and wearing minimalist shoes reduces pain, improves self-reported function, and increases intrinsic foot muscle strength and size, balance, and gait biomechanics, compared to baseline and to the control group.

Being tested
Home Exercise Program, Minimalist Shoes
Keywords
plantar fasciitis, intrinsic foot muscles, minimalist shoes
Medical subject headings
Fasciitis, Plantar

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Home Exercise ProgramBehavioural

    Participants will receive a home exercise program that consists of 2 exercises and 3 stretches. The exercises include:

    • Massage on the bottom of the foot with a ball
    • Calf-raises
    • Lunge calf-stretch with the knee straight
    • Calf-stretch with the knee bent
    • Stretch for the bottom of the foot

    These exercises are intended to be performed daily.

  • Minimalist ShoesBehavioural

    Participants will receive a pair of minimalist shoes. They will wear them for an allotted amount of time per day each week, in order to allow for a slow adjustment into the shoes. The protocol is as follows:

    • Week 1: 1 hour per day
    • Week 2: 2 hours per day
    • Week 3: 4 hours per day
    • Week 4: 6 hours per day
    • Week 5: 8 hours per day
    • Week 6: 8 hours per day
    • Week 7: 8 hours per day
    • Week 8: 8 hours per day
Study groups in NCT06106958
Study groupRoleWhat they receive
Foot Rehabilitation And Minimalist Shoes (FRAMES)ExperimentalThe intervention group will receive a pair of minimalist shoes along with a home exercise program and a protocol that indicates how to slowly adjust to wearing the shoes.
Receives: Behavioral: Home Exercise Program; Behavioral: Minimalist Shoes
Home Exercise Program (Control)Active comparatorThe intervention group will receive a home exercise program.
Receives: Behavioral: Home Exercise Program

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Pain

    Visual Analog Scale (0-100 mm) pain outcome scores for the following items:

    • Average pain over the past week
    • First-step pain over the past week (the pain that is felt upon waking up in the morning and taking a first step)
    • Average heel pain of the day

    Measured: This outcome change will be measured from baseline, to the midpoint of the intervention (4 weeks), to the end of the intervention (8 weeks) for both groups.

  2. Change in perception of overall recovery

    Global Rating of Change (GROC) outcome scores

    Measured: This outcome change will be measured from baseline, to the midpoint of the intervention (4 weeks), to the end of the intervention (8 weeks) for both groups.

  3. Change in self-reported function and health

    Foot Health Status Questionnaire (FHSQ) outcome scores

    Measured: This outcome change will be measured from baseline, to the midpoint of the intervention (4 weeks), to the end of the intervention (8 weeks) for both groups.

  4. Change in foot morphology: length, width, arch height, and girth

    Arch Height Index tool outcome measures

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  5. Change in intrinsic foot muscle size

    Muscle thickness and cross-sectional area of the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis, and quadratus plantae, using diagnostic ultrasound in a weight-bearing position.

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  6. Change in intrinsic foot muscle strength

    Tested separately for the great toe and lesser toes using two different types of handheld dynamometer

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  7. Change in center of pressure (COP) distance during balance

    COP distance using a force plate during a single-limb balance task, eyes open and eyes closed.

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  8. Change in foot posture outcomes

    Clinical foot posture index assessment (23-point scale)

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  9. Change in center of pressure (COP) velocity during balance

    COP velocity using a force plate during a single-limb balance task, eyes open and eyes closed.

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  10. Change in center of pressure (COP) 95% ellipse area during balance

    COP 95% ellipse area using a force plate during a single-limb balance task, eyes open and eyes closed.

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  11. Change in vertical ground reaction force (vGRF) of the rearfoot

    The force (N) during treadmill and overground walking using loadsol sensors

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

Secondary outcomes (14)
  1. Change in kinesiophobia

    Tampa Scale of Kinesiophobia (TSK-11) outcome scores

    Measured: This outcome change will be measured from baseline, to the midpoint of the intervention (4 weeks), to the end of the intervention (8 weeks) for both groups.

  2. Change in fear-avoidance belief

    Fear-Avoidance Belief Questionnaire (FABQ) outcome scores

    Measured: This outcome change will be measured from baseline, to the midpoint of the intervention (4 weeks), to the end of the intervention (8 weeks) for both groups.

  3. Change in pain self-efficacy

    Pain Self-Efficacy Questionnaire (PSEQ) outcome scores

    Measured: This outcome change will be measured from baseline, to the midpoint of the intervention (4 weeks), to the end of the intervention (8 weeks) for both groups.

  4. Change in activity level

    National Aeronautics and Space Administration Activity Survey (NAS)

    Measured: This outcome change will be measured from baseline, to the midpoint of the intervention (4 weeks), to the end of the intervention (8 weeks) for both groups.

  5. Change in vertical ground reaction force (vGRF) of the whole foot

    The force (N) during treadmill and overground walking using loadsol sensors

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  6. Change in vertical ground reaction force (vGRF) of the midfoot

    The force (N) during treadmill and overground walking using loadsol sensors

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  7. Change in vertical ground reaction force (vGRF) of the forefoot

    The force (N) during treadmill and overground walking using loadsol sensors

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  8. Change in average loading rate

    The loading rate (N/s) during treadmill and overground walking using loadsol sensors

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  9. Change in instantaneous loading rate

    The loading rate (N/s) during treadmill and overground walking using loadsol sensors

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  10. Change in knee sagittal plane kinematics

    Knee sagittal plane joint moment (in Nm/kg) measured during the overground gait analysis using markerless motion capture

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  11. Change in hip sagittal plane kinematics

    Hip sagittal plane joint moment (in Nm/kg) measured during the overground gait analysis using markerless motion capture

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  12. Change in ankle sagittal plane kinematics

    Ankle sagittal plane joint moment (in Nm/kg) measured during the overground gait analysis using markerless motion capture

    Measured: This outcome change will be measured from baseline, to the end of the intervention (8 weeks) for both groups.

  13. Change in steps per day

    Steps per day measured on a Fitbit

    Measured: This outcome change will be measured everyday for 8 weeks

  14. Change in activity level per day

    Hours of activity per day measured on a Fitbit

    Measured: This outcome change will be measured everyday for 8 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Oct 2023
  2. Study start14 Feb 2024
  3. Primary completion20 Jan 2025
  4. Study completion20 Jan 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
There will be two groups: 1. Performing foot rehabilitation exercises and wearing minimalist shoes (intervention group) 2. Only performing foot rehabilitation exercises (control group)
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
37 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06106958
Sponsor's protocol ID
HSR230045
Acronym
FRAMES
Status last verified
Jul 2025
First submitted
19 Oct 2023
Last updated
16 Jul 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Barnes A, Sullivan J, Pappas E, Adams R, Burns J. Clinical and Functional Characteristics of People With Chronic and Recent-Onset Plantar Heel Pain. PM R. 2017 Nov;9(11):1128-1134. doi: 10.1016/j.pmrj.2017.04.009. Epub 2017 Apr 28.

    PubMed 28461226
  • Allen RH, Gross MT. Toe flexors strength and passive extension range of motion of the first metatarsophalangeal joint in individuals with plantar fasciitis. J Orthop Sports Phys Ther. 2003 Aug;33(8):468-78. doi: 10.2519/jospt.2003.33.8.468.

    PubMed 12968860
  • Cheung RT, Sze LK, Mok NW, Ng GY. Intrinsic foot muscle volume in experienced runners with and without chronic plantar fasciitis. J Sci Med Sport. 2016 Sep;19(9):713-5. doi: 10.1016/j.jsams.2015.11.004. Epub 2015 Nov 22.

    PubMed 26655866
  • Chang R, Rodrigues PA, Van Emmerik RE, Hamill J. Multi-segment foot kinematics and ground reaction forces during gait of individuals with plantar fasciitis. J Biomech. 2014 Aug 22;47(11):2571-7. doi: 10.1016/j.jbiomech.2014.06.003. Epub 2014 Jun 11.

    PubMed 24992816
  • Wearing SC, Smeathers JE, Urry SR, Hennig EM, Hills AP. The pathomechanics of plantar fasciitis. Sports Med. 2006;36(7):585-611. doi: 10.2165/00007256-200636070-00004.

    PubMed 16796396
  • Jaffri AH, Koldenhoven R, Saliba S, Hertel J. Evidence for Intrinsic Foot Muscle Training in Improving Foot Function: A Systematic Review and Meta-Analysis. J Athl Train. 2023 Nov 1;58(11-12):941-951. doi: 10.4085/1062-6050-0162.22.

    PubMed 35724360
  • Newsham K. Exploring Workload Associated With Learning Foot Core Exercises. International Journal of Athletic Therapy and Training. 2022;27(3):120-128.

  • Ridge ST, Olsen MT, Bruening DA, Jurgensmeier K, Griffin D, Davis IS, Johnson AW. Walking in Minimalist Shoes Is Effective for Strengthening Foot Muscles. Med Sci Sports Exerc. 2019 Jan;51(1):104-113. doi: 10.1249/MSS.0000000000001751.

    PubMed 30113521
  • Warne JP, Gruber AH. Transitioning to Minimal Footwear: a Systematic Review of Methods and Future Clinical Recommendations. Sports Med Open. 2017 Sep 15;3(1):33. doi: 10.1186/s40798-017-0096-x.

    PubMed 28916956
  • Ribeiro AP, Joao SMA. The Effect of Short and Long-Term Therapeutic Treatment with Insoles and Shoes on Pain, Function, and Plantar Load Parameters of Women with Plantar Fasciitis: A Randomized Controlled Trial. Medicina (Kaunas). 2022 Oct 28;58(11):1546. doi: 10.3390/medicina58111546.

    PubMed 36363506
  • Yeasmin Lipa L, Kalita A, Dutta A. A Comparative Study To Find Out The Effectiveness Of Myofascial Release Technique Along With Stretching Versus Myofascial Release Technique In Patients With Plantar Fasciitis. Int J Life Sci Pharm Res. Published online January 31, 2022. doi:10.22376/ijpbs/lpr.2022.12.1.L183-193

  • Rathleff MS, Molgaard CM, Fredberg U, Kaalund S, Andersen KB, Jensen TT, Aaskov S, Olesen JL. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports. 2015 Jun;25(3):e292-300. doi: 10.1111/sms.12313. Epub 2014 Aug 21.

    PubMed 25145882
  • Campitelli NA, Spencer SA, Bernhard K, Heard K, Kidon A. Effect of Vibram FiveFingers Minimalist Shoes on the Abductor Hallucis Muscle. J Am Podiatr Med Assoc. 2016 Sep 2;106(5):344-351. doi: 10.7547/14-084.

    PubMed 27762613
  • Kamonseki DH, Goncalves GA, Yi LC, Junior IL. Effect of stretching with and without muscle strengthening exercises for the foot and hip in patients with plantar fasciitis: A randomized controlled single-blind clinical trial. Man Ther. 2016 Jun;23:76-82. doi: 10.1016/j.math.2015.10.006. Epub 2015 Oct 30.

    PubMed 26654252
  • Xu J, Hertel J, Kuenze C, Jaffri AH, Saliba SA. The effects of performing therapeutic exercises and wearing minimalist shoes on intrinsic foot muscle function and single-leg balance in adults with plantar fasciopathy. Clin Biomech (Bristol). 2026 Jul;137:106869. doi: 10.1016/j.clinbiomech.2026.106869. Epub 2026 May 9.

    PubMed 42155155

Questions about this trial

What is this clinical trial studying?

A study testing Home Exercise Program and Minimalist Shoes in people with Plantar Fascitis and Plantar Fasciopathy, run by University of Virginia at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Pain (time frame: This outcome change will be measured from baseline, to the midpoint of the intervention (4 weeks), to the end of the intervention (8 weeks) for both groups.). The study lists 11 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06106958, which also lists 15 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Jul 2025.

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